Osteochondral lesions of the knee reconstructed with mesenchymal stem cells - results.

BACKGROUND: We present the results of the treatment of osteochondral lesions with the modified sandwich technique with a collagen membrane. The aim of the study was to assess and compare clinical outcomes following the reconstruction of osteochondral lesions in two groups of patients treated with stem cells obtained from blood and with bone marrow concentrate. MATERIAL AND METHODS: The study group comprised 46 patients with MRI-confirmed osteochondral lesions of various aetiology. A group of 21 patients was treated with bone marrow concentrate and 25 patients were treated with mesenchymal cells obtained from peripheral blood. Patients were assessed with the use of KOOS, Lysholm and VAS scales at 6 months, and at 1 and 5 years following the reconstruction. RESULTS: We noted a significant improvement across all scales in 40 patients (86%). A poor outcome was noted in 6 patients. There was a statistically significant superiority of the group treated with stem cells obtained from blood. The analysis of MRI evidence in patients with good and excellent results showed satisfactory reconstruction of the cartilaginous surface and good regenerate integration. At 5 years, a slight decrease in mean clinical assessment scores was seen in both groups of patients. CONCLUSIONS: 1. The modified sandwich reconstruction is an effective modality in the treatment of severe osteochondral lesions of the knee. 2. Slightly poorer outcomes in the group treated with bone marrow concentrate may have resulted from the number of injected stem cells.

Large cartilage lesions of the knee treated with bone marrow concentrate and collagen membrane--results.

BACKGROUND: The study presents to assess the clinical results of cartilage lesion treatment with bone marrow concentrate and collagen membrane. MATERIAL AND METHODS: The study group comprised 54 patients with ICRS grade III or IV lesions. Lesion sizes ranged from 4 to 12 cm(2). The assessment was carried out at one and five years following the surgery with the use of KOOS and Lysholm functional scales and VAS and KOOS Pain scales. RESULTS: A significant improvement was obtained in 52 out of 54 patients across all scales. No complicating infections were noted. The average improvement at one year was 25 points in the KOOS scale and 35 points in the Lysholm scale. After 5 years an insignificant deterioration was noted in three patients. CONCLUSIONS: 1. One-stage reconstruction of large cartilage lesions with bone marrow concentrate is an effective treatment modality. 2. Due to its lower cost it is a valuable alternative to autologous chondrocyte transplantation. 3. The study group requires 2-3 years of further monitoring to clinically verify this treatment modality.

Cartilage lesions of the knee treated with blood mesenchymal stem cells - results.

BACKGROUND: The study aimed to assess long-term clinical outcomes of cartilage lesion treatment with blood stem cells. The analysis of complications of this method was an additional aim. MATERIAL AND METHODS: The study group comprised 52 patients with ICRS grade III or IV lesions of 4 to 12 cm2. The assessment was carried out at one and six years following the surgery with the use of KOOS and Lysholm scales and VAS and KOOS Pain scales. RESULTS: No postoperative infections were reported. Poor outcomes were noted in 2 patients at 12 months following the surgery. Scores improved in across all scales with an average improvement of 23 points in the KOOS scale and 35 points in the Lysholm scale at one year. At 6 years, minor deterioration was reported in 2 more patients. CONCLUSIONS: 1. The reconstruction of large cartilage lesions with peripheral blood stem cells is an effective treatment modality. 2. This method is a valuable alternative to autologous chondrocyte transplantation.